MRI在胫骨平台骨折诊治中的意义

Value of MRI in the diagnosis and treatment of tibial plateau fracture

目的 :探讨MRI在胫骨平台骨折诊治中的价值。方法 :胫骨平台骨折患者 63例 ,所有患者都行MRI及X线检查 ,评价胫骨平台劈裂和塌陷的程度 ,骨折断端是否有软组织嵌入 ,以及合并的韧带和半月板损伤 ,以选择合适的治疗方案。结果 :所有患者都合并不同程度的韧带或半月板损伤 ,单纯劈裂骨折 11例 ,单纯胫骨髁间骨折 3例 ,49例患者有明显的胫骨平台塌陷 ,骨折端有软组织嵌入 17例 ,X线未发现的隐性骨折 7例。 13例患者MRI检查后改变了治疗方案和手术方式。结论 :MRI能清晰的显示X线不能显示的隐性骨折 ,并能同时显示骨折的形态和塌陷的程度 ,以及是否有软组织的嵌入和合并的半月板、韧带损伤 ,为治疗方案、手术方式和入路的选择提供详细的资料。

Objective: To study the value of MRI in the diagnosis and treatment of tibial plateau fracture.Method: Sixty-three cases of tibial plateau fractures were examined preoperatively both under X-rays and MRI,based on the images,fractures were evaluated under the following prospects: the degree of split and depression,whether there was soft tissue between the fracture ends,the accompanied injury of ligament and meniscus,treatments were decided according to the above information.Result: All tibial fractures were accompanied by somewhat injury of ligament or meniscus.There were 17 cases of simple split fractures,3 cases of intercondylar eminence fractures and 49 cases of depression fractures.Seventeen cases had soft tissues inlayed between bone fragments,7 cases had occult fractures having not been revealed by X rays.13 cases changed their treatments after MRI examination.Conclusions: MRI could find occult fractures that couldn't be revealed by X rays,and could be clearly showed the type and degree of fragments displacement,the accompanied injury of ligament or meniscus.It is good for choosing proper treatment,the most favorable type and exposure of operation for the treatment of tibial plateau fractures.